Gender Dysphoria & Anti-depressants

[dreamer_2.0]

Knowing this is an Internet forum and that few of us, if any, are doctors I'm still looking for some feedback and perhaps experience from others.

I've been battling depression and GD for a significant portion of my life but have only recently considered the two linked.

Initially focusing solely on depression, I've been off and on a Paxil prescription for several years but don't find it helping much, if at all. I know for a fact it doesn't help the GD at all. Because of that, I'm curious of there is anyone else out there who is or was on anti-depressants for GD and if they have any suggestions for different meds I could ask my doctor about.

I'm not talking HRT, while that is a topic of interest, it's a ways down the road.

Any thoughts?

[Amy A]

I was on antidepressants for about a year. I think they took the edge off the very bad days but other than that didn't have much effect. I'm personally of the belief that medication should only be a short term solution to help alleviate depression whilst you tackle the cause of the depression. In my case I was sent for Cognitive Behavioural Therapy, but the lady that I saw told me she couldn't really help me, as she didn't feel that gender dysphoria could be treated with the techniques she used, and that the only way I would be able to treat my depression would be to find a way to reduce my GD.
In the end I gave up with the medication as it was having less and less effect (except when I forgot to organise my prescription and ended up going cold turkey). By this point I was in regular counselling and starting to face up to who I am and what I needed to do to be happy. My depression had become so bad that I am now grateful for the UK's strict gun laws; if we had a firearm in the house, I wouldn't be here anymore. My choice ended up being to transition or spend the rest of my life trying to keep depression and suicidal thoughts at bay.
This is only my experience, and I'm sure someone will come along with a more positive experience of anti-depressants, but if your depression is caused by the GD (as mine is) then I don't think that they will help you much at all. I would expect that you would benefit a lot more from a gender therapist.

[giuseppina]

Maybe Paxil is not the right medication for you. Not all medications work for everyone. There is no way to determine this in advance. Selecting an appropriate antidepressant is a trial and error process.

Perhaps there is another antidepressant that will work with tolerable side effects.

[dreamer_2.0]

Hence this post. I'm not looking for medical advice per se but curious about other people's experiences with antidepressants; what helped, what didn't, etc. Though, as Amy A stated, it's possible that no medication would help and that finding a way to reduce the GD would be the only option. My therapist essentially said the same thing based on her experience with other GD sufferers feeling that anti-depressants typically aren't that effective for this.

[Kelly DeWinter]

I had a bit of a different experience with CBT then Amy, I was on anti depressant's for 5 years , due to severe depression brought on by GID, I went to 3 different therapists, and 13 different meds before i found one i could tolerate, i wanted to get off of the meds, so i worked hard o CBT, and now feel great, i'm have peace and best of all im off the anti depressants. My most important focus, was to understand, that I am who i am, i don't need the approval of others. Sure there are things i would/may/reserve the option to change in the future, but identifying the source of your depression and taking control is the most important thing.

[Marleena]

None of the antidepressants over the years seemed to work. HRT was the key for me. Hope it remains that way.

[dreamer_2.0]

Not sure I'm at the stage where I want HRT to be my only option.

[Angela Campbell]

No one wants it to be the only option. For some it is part of the only option though.

[bas1985]

Not sure I'm at the stage where I want HRT to be my only option.

I pretty understand you, maybe for different reasons. I wish I could handle all of this on my own, without any
external intervention. Probably I am in the denial phase. Hope you and me can find the strength to handle this OR the
humility to ask for help.

[Amy A]

Sure there are things i would/may/reserve the option to change in the future, but identifying the source of your depression and taking control is the most important thing.

Whilst I'm glad that CBT worked for you, I don't believe that GD can be treated by it. I have a friend for whom it did wonders but she suffered more from low self esteem and panic attacks; changing ways of thinking and developing strategies was perfect for her. GD isn't, IMHO, something that can be tackled in that way, as something so fundemental as your gender identity can't be rewired by behaviour modification. The medical professions have long since abandoned these techniques for trans people as they recognise that they don't get results. I was only sent to it because I went to my GP and said I was depressed; as soon as I summed up the courage to tell him the truth he started exploring the other options with me. Your last statement, the one I have quoted above, I agree with wholeheartedly, and I'm so happy for you that you've been able to come of the meds :).


Not sure I'm at the stage where I want HRT to be my only option.

I felt like this as well but it felt like every other option led to a dead end. It's not nice feeling like you have no choice but for some of us here that's exactly what happened. The best advice I can give you is to explore your gender identity and come to terms with who you are. Once you know what you need to do to alleviate the GD, whether it be weekend crossdressing, androgenous presentation, gender fluidity or HRT and transition, then you can act on that and hopefully lift yourself out of your depression.

It is an oft-repeated line here but I would still recommend therapy with someone trained in gender dysphoria before working your way through every brand of medication.

EDIT: I've just noticed on another thread that you are already in therapy, yay! How is it going? Do you feel like it's helping you work things out? :)

[Angela Campbell]

I pretty understand you, maybe for different reasons. I wish I could handle all of this on my own, without any
external intervention. Probably I am in the denial phase. Hope you and me can find the strength to handle this OR the
humility to ask for help.

There is no shame in asking for help.

[Kelly DeWinter]

Whilst I'm glad that CBT worked for you, I don't believe that GD can be treated by it. I have a friend for whom it did wonders but she suffered more from low self esteem and panic attacks; changing ways of thinking and developing strategies was perfect for her. GD isn't, IMHO, something that can be tackled in that way, as something so fundemental as your gender identity can't be rewired by behaviour modification. The medical professions have long since abandoned these techniques for trans people as they recognise that they don't get results. I was only sent to it because I went to my GP and said I was depressed; as soon as I summed up the courage to tell him the truth he started exploring the other options with me. Your last statement, the one I have quoted above, I agree with wholeheartedly, and I'm so happy for you that you've been able to come of the meds :).



Thanks for the reply and the encouragement. I hope I did not misspeak, the CBT was effective in treating my depression and in erasing years of the accumulated thought processes that had become associated with being transgendered in this society. Even though the diagnosis was GID for the cause of my depression. I have come to understand after years of reading , that Gender is wired in the brain and that you cannot change how you are wired any more then you can change the color of your eyes, sure you can change cosmetically many parts of your appearance and chemicly change the levels of hormones in your body, so that the outward appearance more matches the inward self. Depression can at times be just a chemical imbalance and a light med treatment plan is effective. Other times things like CBT are helpful. There are different combinations that work for different people. The key is persistence to keep trying until you find what works for you.

[Aprilrain]

I was already full time and on HRT when I found Welbutrin and Abilify to be effective. I've been on it for about a year and a half now. It works. Also not stalling on transition really helped with the depression too. I had FFS, BA, and will be having SRS this coming winter (probably February). Keeping a steady paced, seeing progress and just living my life as the woman I really am helped with the depression.

[Angela Campbell]

That has been key to me so far. As long as I am making progress the depression and other effects of the GD are lessened to the point I can get along. I only feel depressed when I feel like I am not making progress.

[Ariamythe]

I was started on Wellbutrin (generic name Bupropion) in March, 300mg per day. It's worked for me so far and the side effects have been negligible. My therapist basically insisted that I do six months of antidepressants before she'd even consider giving me my hormone treatment papers.

[dreamer_2.0]

Well, I'm starting a new prescription of Efexor in the morning. Sure hope this helps...

[Stephy]

I went on Effexor 10 years ago and it was a lifesaver. I had tried a few other anti-depressants before that which made me feel terrible and one which landed me in hospital for a week. The Effexor relieved me of what I call "black depression" - the feeling that everything is hopeless, not wanting to get out of bed etc. and helped me to function again. It also helped me to stop CDing as it was causing a problem in my marriage. However, now 10 years later, the urge to crossdress has come back as strong as ever. I am still on the Effexor and do not have "black depression", but do feel a discomfort with myself as a male. I'm still trying to figure out what is going on here. Is the Effexor no longer effective? Was the root cause of the problem, my GID, which I managed to suppress for all those years? I don't have the answers yet, but in time maybe I will. Just thought I would share my experience with Effexor.

[Kelly DeWinter]

Dreamer , just remember it takes 6-8 weeks for a anti depressant to become full strength in your body, just do a daily check of how you are doing, if you notice a marked improvement and you can handle the side effects (if any) then its a good anti D for you. If not then it can take 6-8 weeks to go off the meds , then repeat with a different med. I went thru 13 or 14 before I found one that worked for me with minimal side effects. It was worth it , the wait and try , :)

[LeaP]

Depression is common, almost universal, among those with GD, but whether or not it is due to GD or exacerbated by it varies by individual. Bipolar depression runs in my family and, while hormones have helped, I'll probably be taking anti-depressants forever.

Also, watch out for the period 6 weeks or so after starting anti-depressants. A significant percentage of people have a suicidal reaction. I did, and it wasn't pretty.

[dreamer_2.0]

Thanks for sharing your experience, Stephy. I'm hoping it has the life saving effect on me as it did you.

Waiting 6-8 weeks for optimal results is pretty standard for antidepressants although some people have reported positive (or negative, for others) changes in less time. As with virtually everything, time will tell how and when I'll start feeling them work.

Fingers crossed for positive results! They're sure needed...

[JamieTG]

Although I have some GD issues my depression is caused by low levels of the brain chemical serotonin. There are 3 ways to increase your serotonin level; medication, outdoor sunlight, and vigorous aerobic exercise. The right medication really does help and I've had good results with Cymbalta. I also exercise 6 days a week and get outdoors as much as possible. My GD issues did not go away with the medication however I can deal with problems and obstacles much better when I'm emotionally stable and have as positive outlook. Good luck girl, I feel for you.

[Denise_Lafame]

Well, I'm starting a new prescription of Efexor in the morning. Sure hope this helps...

I've been on Effexor for over 15 years now. It helps with the depression and panic attacks to the point where life is live able but it does nothing for the the GID symptoms. Side effects for me are high levels of perspiration when doing even light exercising, loss of libido and worst of all, it takes the joy out of live and the sorrow out of life. I pretty much go along without seeming to care about anything and I hate that feeling.

I have asked to be put on HRT in hopes of alleviating the GID feelings of incongruity of mind and body but my shrink and GP don't think it would help. Kind of stuck. My shrink even said to me that I had managed to live this long with the GID so why not keep coping the way I always have? I got up and walked out after that remark. Talk about not dealing with the cause of the depression, just cover it up.

Anyway that is where I am, still on Effexor for the rest of my life.

Denise

[dreamer_2.0]

6-8 weeks. I'm at 1.5 weeks. Could reeeally use them about now.

[Cheryl123]

Just to echo what others have said, some drugs work for some people, but not for others. I endured depressions for years without even knowing what was happening. All I knew was that on some days I was immobilized ... doing the easiest tasks took enormous effort.. spent hours sitting, staring off into space. Paxil did nothing for me, but Prozac was a miracle. Within a week of taking it, my depressions began to lift.

For me I felt they were chemical in nature, a chemical imbalance which Prozac corrected after a fashion. But life still didn't seem right. I was no longer immobilized, but the price it seems was the inability to experience joy. So I gave up Prozac. I felt I could always come back to it if I had to. The depressions returned but in between I enjoyed life more.

I never linked the depressions to GD until I started HRT a month ago. The depressions have gone, but unlike being on Prozac I feel genuinely happy for the first time in my adult life.

I hope and pray a solution will come for you, Dreamer Girl. There is a rainbow waiting for you, this much I know.

[Rianna Humble]

The discussion has been good, but this thread is drifting further and further away from a TS topic and closer and closer to General Health & Wellness.
Can we try to bring it back on track please?

Kind Regards
Rianna Humble
Moderator, Transsexual Forums & Safe Haven

[LeaP]

I'll channel Kaitlyn here for a moment and say that I don't have enough data points to find the line between GD-related depression and depression that is congenital. I'm still aware that I cycle, for example, but it has become so mild that I don't really notice it much. The fact that the cycling is there tells me the congenital bipolar syndrome is still in play. But the associated highs and lows have had a ceiling and floor installed, so to speak. Is the the ADs or hormones or both? I can't tell at this point (18 months on ADs, a year on hormones). The only way I might is to stop one, the other, or both. Hormones? ... Not happening! AD's? I've thought about it from time-to-time. My therapist became alarmed when I bought it up. Probably not a good idea ...